This study investigates the comparative effectiveness of two church-based intervention strategies with the primary goal of lowering smoking prevalence in an urban black population, East Baltimore. The specific aims are to determine: 1.) the efficacy of a lay-volunteer mediated professionally-guided intensive intervention strategy compared with a strategy using solely self-help materials, 2.) attitudinal and sociodemographic. predictors of cessation in all smokers, 3.) whether there is increased awareness of related cardiovascular risk factors, and 4.) the costs to churches of independently conducting smoking cessation programs. Lay volunteers from churches will assist in intervention design and be trained to conduct smoking cessation programs. The 56 churches in East Baltimore with congregation sizes > 200 will be randomized to either self help or intensive intervention. Materials and design will be refined by 8 focus groups from the community, determining the appropriateness of format, materials and procedures for the target population. Interventions are based on a readiness for change model, behavioral/social reinforcement, and on social learning theory. Participation is expected from 25 churches yielding a total population of 2937 including 1030 smokers. Health fairs held after high volume church services and church events will be used to obtain data on smoking status (biochemically validated), co-morbidity, attitudes, risk factor awareness, social norms, and health beliefs collected at baseline and at a 1 year follow up to determine smoking prevalence. All smokers will be followed prospectively for 1 year to determine quit status and predictors of cessation. This study is significant because it provides:l.) access to interventions for a broad segment of inner city black Americans who would not be reached through the health system; 2.) potential national generalizability as churches are influential in most black communities; 3.) community "ownership" enhancing institutionalization of the program (if found effective).